Individual provider Active NPI

Jill Sarie Castro, PSY.D., LLP

  • Clinical Psychologist
  • Farmington Hills, MI
National Provider Identifier
1124138300
Registry record updated Oct 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6301013351 Issued in MI
Practice address
26105 Orchard Lake Rd
Suite 204
Farmington Hills, MI 48334-4576
Phone
(248) 229-8388
NPI assigned
Aug 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 6301013351 MI Primary

Addresses

Primary practice location

26105 Orchard Lake Rd
Suite 204
Farmington Hills, MI 48334-4576

Mailing address

26105 Orchard Lake Rd
Suite 204
Farmington Hills, MI 48334-4576
Phone (248) 229-8388

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6301013351MIMDClinical Psychologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349222400000",
    "number": "1124138300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26105 ORCHARD LAKE RD",
            "address_2": "SUITE 204",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483344576",
            "telephone_number": "248-229-8388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26105 ORCHARD LAKE RD",
            "address_2": "SUITE 204",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483344576",
            "telephone_number": "248-229-8388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASTRO",
        "first_name": "JILL",
        "middle_name": "SARIE",
        "name_prefix": "Dr.",
        "credential": "PSY.D., LLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2012-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301013351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington Hills, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.